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目的探讨短疗程抗菌药物治疗肝硬化合并原发性腹膜炎的临床疗效及合理性。方法选取2006年1月—2014年6月天津市第二人民医院收治的肝硬化合并原发性腹膜炎患者256例。根据用药疗程不同分为短期组94例与长期组162例。观察两组患者治疗48h或72h的应答率、治愈率以及30d存活率。结果两组患者应用喹诺酮类(左氧氟沙星)、三代头孢、酶抑制剂类抗菌药物的48h或72h应答率、治愈率比较,差异无统计学意义(P>0.05)。两组患者30d存活率比较,差异无统计学意义(P>0.05)。两组肝肾综合征治愈率、30d存活率比较,差异无统计学意义(P>0.05)。结论短疗程与长疗程抗菌药物治疗肝硬化合并原发性腹膜炎的临床疗效相当,但短疗程抗菌药物治疗肝硬化合并原发性腹膜炎更合理。
Objective To investigate the clinical efficacy and rationality of short-course antibacterials in the treatment of primary cirrhosis with primary peritonitis. Methods From January 2006 to June 2014, 256 patients with cirrhosis and primary peritonitis admitted to Tianjin Second People’s Hospital were enrolled. According to different medication course is divided into 94 cases of short-term group and 162 cases of long-term group. The response rate, cure rate and 30d survival rate of the two groups were observed at 48h or 72h. Results There was no significant difference between the two groups in the response rate of 48h or 72h after treatment with quinolones (levofloxacin), third generation cephalosporins, and enzyme inhibitor antibiotics. The difference was not statistically significant (P> 0.05). There was no significant difference in the 30-day survival rate between the two groups (P> 0.05). The two groups of liver and kidney syndrome cure rate, 30d survival rate, the difference was not statistically significant (P> 0.05). Conclusion Short-course and long-course antimicrobial drugs are effective in treating cirrhosis complicated with primary peritonitis. However, it is more reasonable to treat short-course antimicrobial drugs for primary cirrhosis with primary peritonitis.